Takada Junya, Honda Norihiro, Hazama Hisanao, Ioritani Naomasa, Awazu Kunio
Graduate School of Engineering, Osaka University.
Institute for Academic Initiatives, Osaka University.
Laser Ther. 2016 Dec 30;25(4):273-284. doi: 10.5978/islsm.16-OR-22.
Laser vaporization of the prostate is expected as a less invasive treatment for benign prostatic hyperplasia (BPH), via the photothermal effect. In order to develop safer and more effective laser vaporization of the prostate, it is essential to set optimal irradiation parameters based on quantitative evaluation of temperature distribution and thermally denatured depth in prostate tissue. A simulation model was therefore devised with light propagation and heat transfer calculation, and the vaporized and thermally denatured depths were estimated by the simulation model. The results of the simulation were compared with those of an experiment and clinical trial. Based on the accumulated data, the vaporized depth strongly depended on the distance between the optical fiber and the prostate tissue, and it was suggested that contact laser irradiation could vaporize the prostate tissue most effectively. Additionally, it was suggested by analyzing thermally denatured depth comprehensively that laser irradiation at the distance of 3 mm between the optical fiber and the prostate tissue was useful for hemostasis. This study enabled quantitative and reproducible analysis of laser vaporization for BPH and will play a role in clarification of the safety and efficacy of this treatment.
前列腺激光汽化术有望通过光热效应成为一种治疗良性前列腺增生（BPH）的侵入性较小的方法。为了开发更安全、更有效的前列腺激光汽化术，基于对前列腺组织温度分布和热变性深度的定量评估来设置最佳照射参数至关重要。因此，设计了一个包含光传播和热传递计算的模拟模型，并通过该模拟模型估算汽化和热变性深度。将模拟结果与实验和临床试验结果进行了比较。基于积累的数据，汽化深度强烈依赖于光纤与前列腺组织之间的距离，并且表明接触式激光照射能够最有效地汽化前列腺组织。此外，通过综合分析热变性深度表明，光纤与前列腺组织之间距离为3 mm时的激光照射对止血有用。本研究实现了对BPH激光汽化术的定量和可重复分析，并将在阐明该治疗方法的安全性和有效性方面发挥作用。
